Intraoperative Fluid Management and Blood Transfusion Essentials

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Third Spacing (cont) • Not a big consideration for superficial (breast, skin) or peripheral (hand, foot, knee) procedures: 0-2 ml/kg/hr • Some believe that the third spacing concept is overrated and has given anesthesiologists an excuse for overloading patients with fluids
So is third third spacing overrated? • There probably is some some 3 rd spacing, but assumed third space formulas for fluid losses have been too high (e.g., maybe it peaks at 3-4 ml/kg/hr, and perhaps only when the bowel serosal surfaces are fully “exposed exposed”) -Some have assumed as much as 8-10 ml/kg/hr under these conditions: TOO HIGH • Recent studies suggests that conservative fluid management improves outcomes with colon and pulmonary resections (others yet to come?)
Page 1 and 2: Intraoperative Fluid Management and
Page 3 and 4: Perioperative Fluid “Stressors St
Page 5 and 6: Perioperative Fluid “stressors st
Page 7 and 8: Fluid Deficit (cont) • So an 80 k
Page 9: Third Spacing • Controversial Sub
Page 13 and 14: Rational Fluid Management Plan for
Page 15 and 16: Crystalloids • Approximately 25%
Page 17 and 18: Fluid Fluid D5W 0.9% N.S. L.R. Norm
Page 19 and 20: • LR: Which crystalloid to select
Page 21 and 22: Introduction to Transfusion RBCs, R
Page 23 and 24: Therapeutic Dilemma Anemia is bad
Page 25 and 26: Other infectious complications of t
Page 27 and 28: Metabolic Complications of Transfus
Page 29 and 30: Anemia in Elective Surgical Patient
Page 31 and 32: So Goodnough et al. are recommendin
Page 33 and 34: ASA Practice Guidelines • Transfu
Page 35 and 36: RBC Transfusion Modifiers Primary a
Page 37 and 38: Indications for Fresh-frozen plasma
Page 39 and 40: Fibrinogen concentration vs blood v
Page 41 and 42: Platelet transfusion won’t won t

Intraoperative Fluid Management and Blood Transfusion Essentials

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